Obama Retreats on Contraception

By

Louise Radnofsky,

Laura Meckler and

Carol E. Lee

February 11, 2012

Some Catholics expressed relief but others were unmoved after President Barack Obama on Friday loosened a requirement that religious employers cover contraception in health plans, an issue that had turned into a political firestorm in recent weeks.

President Obama on Friday announced a new policy that no longer requires a broad swath of religious organizations to provide employees with contraception coverage in health-insurance plans. Laura Meckler discusses on The News Hub. Photo: AP

Under the new policy, religious employers opposed to most forms of birth control wouldn't be required to directly pay for such coverage in their workers' insurance policies. Instead, insurance companies would be required to offer contraception without explicitly charging either the religious employer or worker. That shift means the cost of providing the coverage to religious employers is likely to be spread across all policyholders by insurers.

Bishops who had led opposition signaled the change could satisfy some concerns but "we reserve judgment on the details until we have them," said Archbishop Timothy Dolan, president of the U.S. Conference of Catholic Bishops. "Today's decision to revise how individuals obtain services that are morally objectionable to religious entities and people of faith is a first step in the right direction."

Friday's announcement won over some Catholic leaders, but parishioners were divided.

"Government doesn't have a place telling Catholic institutions what they have to do. Not just Catholics, but any religious institution," said Jo-Ann Corsillo, a 53-year-old accountant and practicing Catholic in New York City. "I think that government should basically butt out."

Frank Franz, a 58-year-old practicing Catholic from the Bronx, N.Y., said he supported the compromise: "Someone who believes in birth control and wants to use it should have access to it, but you shouldn't make someone who opposes it provide it."

In a year where the economy was supposed to dominate the November elections, the contraception backlash showed that social issues could have a powerful influence on the race. Republicans used the controversy to paint Mr. Obama as assailing religious rights—and adding another black mark against the 2010 health overhaul that spawned the policy.

The debate also exposed a rift within the White House that pitted some Catholics against high-level women in the administration who argued for broad contraceptive coverage.

Aides said Friday's settlement showed the president fighting for birth-control access, an issue popular among independent women who are key to the 2012 election.

"No woman's health should depend on who she is or where she works or how much money she makes," Mr. Obama said in televised remarks from the White House. "As we move to implement this rule, however, we've been mindful that there's another principle at stake here—and that's the principle of religious liberty… As a citizen and as a Christian, I cherish this right."

Under the health care law passed in March 2010, insurers must cover preventive care at no out-of-pocket cost for consumers. The Institute of Medicine recommended that contraception be included on the list of covered services. The Obama administration said last month it would include contraception when the preventative care requirement takes effect in August.

That spawned a backlash. Catholic priests and bishops had railed against the policy in Sunday masses. GOP lawmakers and presidential candidates slammed the White House for what they described as an assault on religious liberty and some Democrats also voiced concerns.

Before the president spoke Friday, he telephoned Archbishop Timothy Dolan, head of the U.S. Conference of Catholic Bishops; Sister Carol Keehan, head of the Catholic Health Association; and Cecile Richards, head of Planned Parenthood, to discuss the shift, an administration aide said. Sister Keehan and Ms. Richards were among the first people to praise the announcement.

Sister Keehan said she was "pleased and grateful that the religious liberty and conscience protection needs of so many ministries that serve our country were appreciated enough that an early resolution of this issue was accomplished." She gave her backing to the health care overhaul law during some of the most contentious debates over it.

Several Republican lawmakers, however, described the policy as a "fig-leaf" in press releases, and the leaders of Concerned Women for America, a conservative group, described it as "inane."

GOP presidential candidate Rick Santorum said he was "not at all" satisfied. "This is a war of government trying to use its power to force you to do things," he said Friday at the Conservative Political Action Conference in Washington.

A key issue for the bishops and Catholic ethicists will be determining whether the proposals adequately shield religious employers from facilitating access to contraception.

Such liberal Catholic groups as Catholics United praised the decision, but others, such as Catholics for Choice, said the administration had given "victory number one to the bishops."

Sandra Fluke, a student at Georgetown University's law school who campaigned for access to contraception for students at Catholic institutions, said that she was "really thankful."

The Rev. John Jenkins, president of the University of Notre Dame, said in a statement that he "applaud[ed] the willingness of the administration to work with religious organizations to find a solution acceptable to all parties."

Supporters of the policy change say it won't cost insurers extra because contraceptive services are cheaper to provide than maternity coverage. A report by Department of Health and Human Services officials found that previous expansions of contraception coverage had zero cost increase.

Others disagreed. "There is no free lunch and there is no free contraception," wrote Bob Laszewski, a health care consultant and former insurance executive, in a blog post Friday.

The insurance industry was caught by surprise. Industry officials said they learned of the decision early Friday without any discussions with the Obama administration over how it might work or how much it would cost.

Obama, hoping to quell a political backlash, announced a new policy that no longer requires religious organizations to provide employees with contraception coverage. Louise Radnofsky has details on Lunch Break.

"Aetna certainly will comply with the policy announced today, but we need to study the mechanics of this unprecedented decision before we can understand how it will be implemented and how it will impact our customers," said Mohit Ghose, a company spokesman.

The decision left people on both sides of the debate wondering why the administration had not proposed this solution from the start.

Late last year, the White House appeared to be leaning toward a broader exemption for religious organizations. Archbishop Dolan, for instance, came away from a conversation with Mr. Obama optimistic the president was sympathetic to his concerns. But the delay in issuing the regulations gave advocates time to lobby the White House the other way.

Internally, the pro-coverage views were championed by Health and Human Services Secretary Kathleen Sebelius, while others in the administration, including Vice President Joe Biden and then-Chief of Staff Bill Daley, argued the requirement would be read by some Catholic leaders as an intrusion into religious liberty. Denis McDonough, one of Mr. Obama's deputy national security advisers who has advised the president on Catholic issues, also supported the Catholic perspective.

Administration officials considered a model like one used in Hawaii, where religious employers who exclude contraception from their plans pay a reduced premium. But lawyers concluded that model was unworkable nationwide.

From the start, Mr. Obama had misgivings about the policy announced last month. He was uncomfortable issuing a policy that would be read as offensive to people like Sister Carol, who had worked with the White House, according to people familiar with his thinking. But he was told that other options would leave large numbers of women without access to contraception.

The policy allowed a year's delay for religious groups. The president believed that would be enough time to find a solution that accommodated all sides. But the political reaction quickly grew fierce, dominating conversation in Washington. The backlash caught the president's advisers off guard.

Late last week, Mr. Obama ordered aides to speed up the review and find an accommodation quickly, the president said Friday.

Mr. Obama's advisers held a series of phone calls and meetings to find a way out. The challenge, people familiar with the discussions say, was to find a solution that quelled the controversy but didn't reverse the president's core principle of ensuring women had access to contraceptives. Politically, the president's advisers feared a compromise alienated both Catholic leaders and women's groups that backed the birth control coverage.

Mark Childress, the newly appointed White House deputy chief of staff, was assigned to lead the review. A lawyer who had worked at HHS and on Capitol Hill, he has been charged with "quarterbacking" thorny political policy matters, one aide said. He brought fresh eyes to the problem, other people familiar with the process explained. Officials again looked at the Hawaii model and again were told it was unworkable nationally. The final solution was a variation on that approach, one that was never considered in the first round of discussions, officials said.

WSJ opens select articles to reader conversation to promote thoughtful dialogue. See the 'Join the Conversation' area to the rightbelow for stories open to conversation. For more information, please reference our community guidelines. Email feedback and questions to moderator@wsj.com.

Obama Retreats on Contraception

Some Catholics expressed relief but others were unmoved after President Barack Obama on Friday loosened a requirement that religious employers cover contraception in health plans, an issue that had turned into a political firestorm in recent weeks.